I am happy to provide with you some information on this subject. Cutting is generally a way of expressing emotional pain in a physical outlet. While it is very disturbing to see someone harming themselves in this way it is important to understand that this is different from suicidal behaviors. Cutting is generally one of many symptoms of depression.

When Your Child Is Cutting: A Parent's Guide to Helping Children Overcome Self-injury by Merry E

A Bright Red Scream: Self-Mutilation and the Language of Pain by Marilee Strong

Some steps in addressing depression include:

1. Identify that you want to change this pattern of negativity in your life. This is a powerful and courageous decision. Have a thorough assessment from a qualified clinician (medical doctor, psychotherapist, psychologist or psychiatrist. Some good resources are: your HMO, local mental health agency or hospital, Primary Care Physician, or a professional source that you trust.

2. When necessary, begin the process of therapy, which can be short term or long term. Therapy is a partnership between an individual and a therapist, a shared experience of mutual trust and confidentiality. The therapist is a good listener and support person. The process of self reflection in therapy enables a person to sort out both positive and negative feelings. It can help improve communication and encourage expression of hidden feelings that have caused sadness. As a person becomes aware of the problems causing the depression, develops solution strategies, has more self understanding and compassion, the door is open for a change in belief system.

3. Learning what triggers negative thoughts is a key factor. Depression can be experienced in cycles, with different intensities. Cycles of the seasons, holidays, and aging cycles can trigger depression. People prone to depression may get more depressed when their life changes (i.e. a move, job change or a loss) or when there is a health or relationship crisis.

4. Changing one’s habitual thinking patterns is important. Recycling the negative thoughts over and over also reinforces the depression. Continually thinking that “Life will never get better.” Or “I will always be a failure.” influences the depth and length of the depression. Therefore, changing one’s thinking patterns from self judgment to compassion, from hopelessness to hopeful is necessary. Therapeutic techniques that reframe negative thinking i.e., cognitive exercises, positive reinforcement, breathing, meditative and relaxation exercises, as well as other therapeutic techniques, all seem quite beneficial.

5. Understanding how to “empower yourself” by taking responsibility for your own health and well being, while not blaming others for your problems is critical. Disconnecting from the negative patterns which keeps you powerless and focusing on positive life patterning helps to increase self esteem, i.e., healthy diet and exercise regimen; fulfilling and joyful connection to family and friends, a sense of humor, involvement in hobbies, music, theater, dance, art; relaxation techniques, positive affirmations, yoga, TaiChi; having someone to confide in, asking for help, reaching out to help others, joining a support group, improving communication within relationships and learning to problem-solve. And there are many more. You can use your own creativity to bring the positive into your life. Sometimes you just need someone to help light the way.

Exercise, eating right and journaling can all be good ways of dealing with the feelings that you are experiencing. If you feel that you need to share feelings, you might try writing a letter to yourself and then writing a letter back as if you were responding to someone you care about. This can often be helpful to allow you to begin nurturing yourself. Also, if things get to be too difficult, reach out to a crisis line, emergency room or to your doctor for help.

Some good books about depression include:

Feeling Good: The New Mood Therapy Revised and UpdatedBy David D. Burns

The Depression Workbook: A Guide for Living with Depression and Manic Depression, Second EditionBy Mary Ellen Copeland, Matthew McKay

I hope this is helpful. Please let me know if I can help further.

JACUSTOMER-8w6opqf9- :

As a concerned aunt to an 18 year old niece who has been cutting, and recently been prescribed with antidepressants, what can I do to help?

Lori Gephart :

I am sorry to hear about the problems your niece is experiencing. One of the most important things that you can do to help is to offer unconditional love and support. You can encourage your niece to be involved in individual therapy with a psychologist who specializes in this area, in addition to being on the medication. Also, finding ways to interact with her in ways that allow her to feel accepted for who she is, despite the problems going on, such as taking her out to eat, for a walk, or just giving her a place to feel understood can be helpful.

Letting her know that you care about her and that she doesn't have to be perfect in order to be loved is one of the most important things that you can offer. Having someone in her life who gives her unconditional love can help her to be resilient. Encouraging exercise as a positive way of improving mood can be helpful. Please let me know if I can help further.

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